[Valsalva leak point-pressure (LPP) and maximal urethral closure pressure (MUCP) in women with stress urinary incontinence (SUI)].
One-hundred and twenty-two women with USI have been evaluated with clinical examination and urodynamics and divided in two groups: only in 74 patients with urinary loss during the Valsalva manoeuvre, LPP was compared to MUCP by linear regression analysis and its ability (cut-off = 60 cmH2O) to predict a MUCP < or = 20 cmH2O was tested. Weak correlations were observed between MUCP and LPP (r = 0.56). Fifty-two patients presented a LPP < or = 60 cmH2O, in 6 of them MUCP was < or = 20 cmH2O; none with LPP > 60 cmH2O showed a MUCP < or = 20 cmH2O. Median MUCP and intravesical pressures at the instant of leakage of patients with LPP < or = 60 cmH2O were significantly different from those of patients with LPP > 60 cmH2O (p < 0.01). The specificity and positive predictive value of LPP < or = 60 cmH2O for the detection of a "low pressure urethra" were respectively 32% and 11.5%, while sensibility and negative predictive value were 100%. LPP can not be regarded as a specific test for urethral sphincteric deficits. For its sensibility, it can be an useful screening tool for patients at high risk of type III urinary incontinence.
Larosa
M
M
Divisione di Urologia, Azienda Ospedaliera di Parma. sp01502@pn.itnet.it
Simonazzi
M
M
Barbieri
A
A
Pozzoli
G L
GL
Cortellini
P
P
D000368:Aged; D005260:Female; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014521:Urethra / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000503:physiopathology*; D014563:Urodynamics; D014636:Valsalva Maneuver
Valsalva leak point-pressure (LPP) e massima pressione di chiusura uretrale (MUCP) in donne con incontinenza urinaria da stress (IUS).